Journal Article

Fatal <i>Mycobacterium tuberculosis</i> Bloodstream Infections in Febrile Hospitalized Adults in Dar es Salaam, Tanzania

Lennox K. Archibald, Meyno O. den Dulk, Kisali J. Pallangyo and L. Barth Reller

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 26, issue 2, pages 290-296
Published in print February 1998 | ISSN: 1058-4838
Published online February 1998 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/516297
Fatal Mycobacterium tuberculosis Bloodstream Infections in Febrile Hospitalized Adults in Dar es Salaam, Tanzania

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Causes of community-acquired bloodstream infections (BSIs) in sub-Saharan Africa are unknown with regard to mycobacteria and fungi. We prospectively studied 517 consecutive febrile (axillary temperature, ⩾37°57C) adults (⩾15 years of age) admitted to one hospital in Tanzania. After hospital admission and informed consent, blood was drawn for culture (of bacteria, mycobacteria, and fungi), determination of human immunodeficiency virus type 1 (HIV-1) status, and malaria smears. Malaria smears were prepared for a control group of 150 afebrile patients. One hundred and forty-five patients (28%) had BSI. Of these 145 patients, 118 (81%) were HIV-1-infected. HIVpositive patients were more likely than HIV-negative ones to have BSI (118 of 282 vs. 27 of 235; P < .0001). The three most frequently isolated pathogens were Mycobacterium tuberculosis (60 [39%]), non-typhi Salmonella species (29 [19%]), and Staphylococcus aureus (13 [8.3%]). The incidence of malaria parasitemia was similar in study and control patients (9.5% vs. 8%). In this patient population with high prevalence of HIV-1 infection, M. tuberculosis has become the foremost cause of documented BSI.

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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